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What Causes Sleepwalking and How Can You Prevent It?

written by / September 5, 2022
What Causes Sleepwalking - Featured

Sleepwalking or somnambulism is a relatively common behavioral disorder. It’s characterized by walking or performing other complex actions during the deep sleep phase. 

But what causes sleepwalking? Is it genetic, or are there some external factors that trigger it?

Join us as we shed some light on this medical mystery.

Sleepwalking — General Facts

Sleepwalking typically occurs during the deep sleep stage, but it can also happen in the more superficial phase of NREM sleep. It usually happens a few hours after falling asleep, when the sleeping person may be in a lighter sleep mode.

It’s a common hereditary sleep disorder found in roughly 5% of children and 1.5% of adults. So, if your mom, dad, or somebody else in your family had it, chances are you will too! As a matter of fact, you’re five times more likely to sleepwalk if you have a somnambulist identical twin. 

And yes, the crazy stories you must have heard about sleepwakers are true. They can do many things in their sleep, including jumping out of windows, driving cars, going barefoot outside at -20 ºC without feeling pain or discomfort, and even swimming! 

No wonder many of their nocturnal adventures end up causing injuries. 

But are sleepwalkers conscious? 

The sleepwalker is asleep, but their body is active, allowing them to perform complex actions such as speaking, talking, or walking out of the house and performing a plethora of other complex actions. 

So, the answer is no. Sleepwalkers aren’t conscious during a sleepwalking episode and typically can’t remember what they were doing the night before. Moreover, they’re often surprised to hear what’s occurred or to find bruises and other injuries on their bodies. 

Sleepwalking and Dreaming

Contrary to popular belief, sleepwalkers don’t dream while they’re sleepwalking. And, no, they aren’t acting out scenes from their dreams during their sleepwalking episodes. 

This is because sleepwalking doesn’t occur in the REM (rapid eye movement) phase, which is when dreams occur. Instead, you’ll find them sleepwalking while in the deepest stage of NREM sleep. 

What Part of the Brain Controls Sleepwalking?

Research suggests that when you sleepwalk, you aren’t necessarily wholly asleep. In fact, only part of your brain is sleeping,” while other parts are wide “awake.” 

The limbic region (the part dealing with raw emotions) and part of the cortex responsible for motor activity are the ones that remain awake and cause sleepwalking. 

At the same time, the frontal cortex (responsible for rationality) and hippocampus (responsible for memory), which should keep the other two under control, are sound asleep.

Can You Remember Sleepwalking? 

Since sleepwalkers are in an altered state of consciousness during an episode (which may last from a couple of seconds to about 10 minutes), they don’t know they’re sleepwalking. 

Therefore, they typically have no recollection of what they were doing during their sleepwalking episodes. 

However, there are cases when sleepwalkers have vague impressions of certain moments or can remember thoughts they had or emotions they felt during an episode.

Sleepwalking Symptoms

The most common symptoms include: 

  • Sitting in bed with a blank expression on your face
  • Repeating movements while seated on the bed (e.g., tugging pajamas, rubbing eyes)
  • Leaving the bed and walking around
  • Screaming (occurs when somnambulism co-occurs with night terrors)
  • Talking in your sleep
  • Not responding to communication (or responding in a nonsensical manner)
  • Being difficult to wake up during a sleepwalking episode
  • Short-lasting disorientation or confusion after being awakened
  • Not remembering the episode in the morning
  • Fatigue and inability to function in the morning due to disrupted sleep

As mentioned above, somnambulists can perform various complex actions during sleepwalking episodes. 

For example, they can: 

  • Perform routine activities (e.g., speak, prepare food, eat, get dressed, etc.)
  • Rearrange furniture
  • Leave the house (sometimes even through a window)
  • Drive (sometimes even significant distances)
  • Engage in a sexual act
  • Urinate in inappropriate places (e.g., in the closet)
  • Act violently (sometimes even for a short period after waking up)

Causes of Sleepwalking

There are many reasons why sleepwalking may occur:

  • Genetics (sleepwalking may run in the family)
  • Being a child (somnambulism is more frequent in children than in adults)
  • Sleep disruptions (including travel-related sleep disruptions)
  • Extreme fatigue
  • Stress and anxiety
  • Fever
  • Substance/alcohol abuse
  • Going to bed with a full bladder
  • Environmental stimuli (e.g., noises or touches)
  • Changes in sleep environment (e.g., sleeping at a hotel), etc.

For some, underlying medical conditions can be the causes of sleepwalking:

  • Obstructive sleep apnea
  • Restless legs syndrome
  • Magnesium deficiency
  • Head injury
  • Migraine
  • Stroke
  • Pregnancy
  • Menstruation
  • GERD
  • Hyperthyroidism
  • Depression and other mental health disorders, etc.

The use of certain medications can also trigger somnambulism. 

Medications that cause sleepwalking include:

  • Various sedatives, hypnotics, and sleeping pills (e.g., chloral hydrate, eszopiclone, zaleplon, zolpidem, and many others)
  • Various medications for treating psychiatric disorders (e.g., phenothiazines, lithium, and many others)
  • Certain antihistamines

Sleepwalking in Children

Sleepwalking in children is more common than in adults. According to statistics, one in five children has a sleepwalking episode at least once and 15% of children aged five to twelve walk in their sleep.

In most cases, children “outgrow” somnambulism before they reach the teen years. One of the reasons for this might be that the deep sleep phase (the phase when sleepwalking most commonly occurs) gradually shortens as the child gets older.

Therefore, children usually don’t require any specific treatment when it comes to sleepwalking.

What Causes Sleepwalking in a Child

Sleepwalking causes in children don’t differ much from those in adults. 

They include: 

  • Genetics (a family history of night terrors)
  • Illness or fever
  • Certain medicines
  • Lack of sleep
  • Irregular sleep schedule
  • Fatigue
  • Noisy or unfamiliar sleeping environment
  • Going to sleep with a full bladder
  • Emotional and psychological problems
  • Stress and anxiety (separation anxiety, etc.)

Sleepwalking in children is also commonly associated with bedwetting.

How Is Sleepwalking Diagnosed?

Anyone that’s had more than one episode of somnambulism should visit a doctor for a thorough review. 

The doctor will examine the patient’s medical history and current state of health. They’ll also perform a physical exam to exclude other conditions commonly confused with sleepwalking (e.g., other sleep disorders, panic attacks, nighttime seizures, etc.). 

The doctor will also discuss your sleepwalking symptoms and ask you whether you perform certain actions (eating, getting dressed, etc.), leave your home, get injured while sleepwalking, etc. 

So, it’s a good idea to discuss what you do while asleep with your sleep partner or ask them to join you at the doctor’s appointment. 

It’s also useful to keep a sleep diary where you’ll document the symptoms your sleep partner describes to you as well as factors that may have triggered the episode

  • What happened (what actions and movements you made)
  • When it happened
  • How long it lasted
  • What you dreamt about
  • How you felt when you woke up
  • What you ate and drank (especially before going to bed)
  • Whether you engaged in physical activity, etc.

Blood tests may also be performed to rule out a possible hormonal imbalance (some studies suggest there’s a connection between hormonal changes and sleepwalking).

Polysomnography is another useful diagnostic tool. To determine whether you’re indeed a sleepwalker, your doctor may schedule you for an overnight sleep study in a lab where they’ll monitor your:

  • Leg and eye movements
  • Breathing
  • Blood levels of oxygen
  • Heart rate
  • Brain waves (EEG is crucial here, as 47% of parasomnia patients tend to have abnormal results)

Can Sleepwalking Be Dangerous?

This is a natural question that arises after becoming familiar with the most common symptoms of somnambulism. Especially once you find out that a somnambulist is perfectly capable of driving a car or shooting a weapon during one of their episodes. 

Though most sleepwalking episodes pass with no significant consequences (this is why sleepwalking isn’t considered a dangerous condition from a medical standpoint), there’s still a danger of sleepwalking and hurting yourself

For example, you could fall down the stairs, bump into the walls or furniture, or even try to jump out the window without realizing it. 

Moreover, a small-scale study showed that 57.9% of sleepwalkers expressed violent behavior during episodes, while 17% suffered injuries that required medical attention during at least one sleepwalking episode.

Unfortunately, sleepwalking-related injuries may sometimes prove fatal (e.g., accidentally falling from a height and suffering head injuries). But this is an extremely rare occurrence, according to sleepwalking death statistics.

How to Prevent Injuries

There are some steps you can take to protect a sleepwalker from physical harm: 

  • Place the mattress directly on the floor or use a sleeping bag.
  • Pad the floor around the bed. 
  • Pad the sharp edges of furniture near the bed.
  • Lock windows and doors that lead outwards.
  • Remove all sharp and potentially dangerous objects (including mirrors) from the bedroom.
  • Hide and lock away any weapons.
  • Remove anything a sleepwalker could trip on from the bedroom.
  • Install alarms on the bedroom door and windows.
  • Place a barrier at the top of the staircase.
  • If the house has several floors, make sure that the sleepwalker’s bedroom is on the ground floor (if possible).

Are You Supposed to Wake Up a Sleepwalker?

You must have heard that if you wake up a sleepwalker, they’ll immediately suffer a heart attack or fall into a coma. This is the most common misconception related to sleepwalking. 

Sleepwalkers are often at risk of injuring themselves during their sleepwalking episodes, so doing something to save them from harm is actually desirable. The best thing to do is to try to ease them back to bed. 

And if you really feel it’s necessary to wake them up, do so slowly and gently to avoid them feeling startled or overly confused and disoriented after. 

Also, bear in mind that sleepwalkers can exhibit violent behavior towards the person trying to awaken them.

How Do You Fix Sleepwalking?

Occasional sleepwalking usually doesn’t require any kind of treatment. Neither does sleepwalking in children (since this condition typically goes away on its own once the child reaches teen years). 

However, if you’re an adult and sleepwalking disturbs your (and your loved ones’) sleep and affects your everyday life, you should seek treatment. 

So, what can you do?

Currently, there’s no specific treatment for somnambulism. The treatment will largely depend on the cause and may include: 

  • Adjusting medications (if sleepwalking was caused by medications)
  • Treating underlying medical conditions (e.g., obstructive sleep apnea, restless legs syndrome, GERD, etc.)
  • Self-hypnosis
  • Therapy and counseling 
  • Taking certain medications (sedatives and antidepressants (e.g., lorazepam, clonazepam, diazepam, amitriptyline, trazodone, etc.))

One of the good ways to try to stop sleepwalking in children is to wake them up 15–30 minutes before they typically start having a sleepwalking episode, keep them awake for several minutes, and then let them fall asleep again. 

This should be enough to alter their normal sleep cycle and prevent future sleepwalking episodes.

How to Stop Sleepwalking — Sleepwalking Prevention

In most cases, improving your sleep pattern and maintaining proper sleep hygiene is enough to reduce the number of your sleepwalking episodes. Applying certain relaxation techniques before going to bed might also prove helpful. 

Check out the space you sleep in. Your sleeping environment should be safe and cozy. So, if your mattress is old and deformed, replace it with a new quality mattress and get rid of all things that don’t belong in the bedroom.

Conclusion

Sleepwalking is a medical condition that deserves our attention, primarily because of its impact on quality of life and the risk of possible trauma. 

Knowing all the causes of sleepwalking and what to do when you encounter a sleepwalker can help you avoid the condition’s unpleasant consequences and complications. And it might help you identify a deeper underlying problem early.

FAQs

Does sleepwalking run in families?

A clear genetic connection is the most definite predisposing factor for sleepwalking. However, several mitigating measures focus on sleepwalking’s other causes. If these are managed well, then even those with a hereditary predisposition for sleepwalking should see improvement.

Does sleepwalking go away?

When episodes occur once or twice a month, treatment isn’t necessary. You have to remember that sleepwalking is seldom a dangerous condition and will likely go away on its own when your child reaches the teen years.

Is it bad to wake up a sleepwalker?

As explained above, waking up a sleepwalker isn’t necessarily bad. Contrary to popular belief, they won’t get a heart attack or fall into a coma because of this. They’ll just feel very confused and disoriented. 

How do I stop my child from sleepwalking?

You can help your child by ensuring they maintain a regular sleep regimen and making sure they get enough sleep. 

Try to create a soothing environment in the bedroom — get a comfortable bed and curtains for dimming the room. Don’t forget to maintain a lower temperature. Another important factor is helping your child control any stress or anxiety.

If your child experiences sleepwalking episodes frequently, try to wake them up 15–30 minutes before they typically start having a sleepwalking episode, keep them awake for several minutes, and then let them fall asleep again. 

This should be enough to alter their normal sleep cycle and prevent future sleepwalking episodes.

What triggers sleepwalking?

A variety of factors can cause sleepwalking, from genetics to various external factors like medications and unfavorable sleeping environments. 

Here’s a short list of some of the most common causes of sleepwalking in adults:

  • Genetics
  • Disturbed or unproductive sleep due to sleep apnea
  • Sleep deprivation or exhaustion
  • Stress and anxiety
  • Noises or physical contact
  • Migraine
  • Head injury
  • Particular medications (e.g., sleeping pills)
  • Alterations in sleep environment or sleep settings (e.g., sleeping at a hotel)

Is sleepwalking caused by stress?

Yes. In some cases, sleepwalking can be one of the negative effects of stress

What causes sleepwalking in children?

The reasons why children sleepwalk aren’t that different from the reasons why adults do. 

So, let’s take a look at the most common causes, that is, what causes sleepwalking in our little ones most frequently: 

  • Genetics 
  • Fever
  • Certain medications
  • Lack of sleep
  • Irregular sleep
  • Fatigue
  • Noisy or unfamiliar sleeping environment
  • Going to sleep with a full bladder
  • Emotional and psychological problems
  • Stress and anxiety

At medical school, it was easy to realize that sleep is crucial while studying during the many sleepless nights I spent. As a new mom, when the lack of sleep became even more evident, this was the real moment when I started appreciating the benefits of a good night’s sleep. Since sleeping is so essential to our health and immune system, I took it upon myself to educate people on different aspects of sleep by sharing the valuable information I have learned.


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